Care Home: Summerville Nursing Centre

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What the care home does well We observed that staff had a positive, caring and respectful attitude towards the people they were caring for. All relatives we spoke with during out visit said, "the staff are lovely but there aren`t enough of them", "the staff work hard", "the staff are very nice but always rushed". Social activities are provided for the people who wish to join in and people can choose whether they wish to spend their time in one of the lounges or in their own room. Medicines in the home are well managed and records showed that people receive what has been prescribed for them by their doctor. Staff have received training so that they are able to make sure that people living in the home are protected from abuse. What has improved since the last inspection? The managers of the home are dealing with the issue we raised at the visit we made in November about staffing numbers and skill mix by recruiting more care staff for days and more nurses for night duty. The way in which complaints are logged has improved and the complaints file had been put in to a better order so an audit trail could be followed. It now shows the complaint, how it was dealt with and the outcome so that we could see that complaints and concerns are listened to and action is taken to deal with them. Meetings are being held with senior managers to improve the communication with people who live at the home and their visitors. This will also help to make sure that people`s concerns are listened to and acted upon. What the care home could do better: Agreements for people to move into Summerville should not be made unless it can be shown clearly that the person`s needs can be met at the home. This is to make sure that people`s needs are properly considered, including how those needs will be met once the person moves in. Care plans should be kept under review and checked to make sure that they reflect any changes to care needed when people`s conditions change. This is to make sure that staff always have accurate up to date guidance on how to meet each person`s needs. Further improvement is needed in the way that complaints and concerns about the home are dealt with so that people can be confident their concerns will be listened to and acted upon. The staffing levels and skill mix of staff working at the home, especially at night, should be assessed and steps taken to make sure they are adequate to fully meet the needs of the people living at Summerville. All staff should have up to date training on how to move people safely and all the necessary recruitment checks for new staff should be obtained before they start working with the people who live at the home. These steps will help to make sure that the staff are suitable to work with the people who live at Summerville and can provide safe care for them. Key inspection report Care homes for older people Name: Address: Summerville Nursing Centre Hilltop Road Stockton Heath Warrington Cheshire WA4 2EF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joan Adam     Date: 1 5 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Summerville Nursing Centre Hilltop Road Stockton Heath Warrington Cheshire WA4 2EF 01925265865 01925212620 livingno@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Clacy Mrs Janette Margaret O`Hanlon Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 45). Physical disability: Code PD (maximum number of places: 6). The maximum number of people who can be accommodated is: 45. Date of last inspection Brief description of the care home Summerville Nursing Home has recently been taken over by BUPA. It is situated on the border between the Stockton Heath and Grappenhall areas of south Warrington. There Care Homes for Older People Page 4 of 28 Over 65 45 0 0 6 Brief description of the care home is ample care parking space and a good public transport network around the home. It is within easy reach of Warrington town centre, the M6 and M56 motorways. The home is a large period house set in its own grounds by the Bridgewater canal. The original building has six large bedrooms, a bathroom, lounge, dining room, kitchen, laundry, staff facilities and office accommodation. A large purpose built extension houses thirty-seven bedrooms, two smaller lounges and bathrooms. All residents have access to the nurse call system. The charges range from #480 to per #620 week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited Summerville care centre unannounced on 15 December 2009 as part of this inspection. We had completed a short visit to the home in November 2009 because of concerns raised by complaints made by some people who visit the home. During this visit we spoke with people who live in the home, staff and some visitors. We walked round the building to see all the communal areas and some of the bedrooms. We checked records kept at the home and spent time talking with an acting manager and a representative from BUPA, the organisation that runs the home. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Agreements for people to move into Summerville should not be made unless it can be shown clearly that the persons needs can be met at the home. This is to make sure that peoples needs are properly considered, including how those needs will be met once the person moves in. Care plans should be kept under review and checked to make sure that they reflect any changes to care needed when peoples conditions change. This is to make sure that staff always have accurate up to date guidance on how to meet each persons needs. Further improvement is needed in the way that complaints and concerns about the home are dealt with so that people can be confident their concerns will be listened to and acted upon. The staffing levels and skill mix of staff working at the home, especially at night, should be assessed and steps taken to make sure they are adequate to fully meet the needs of the people living at Summerville. All staff should have up to date training on how to move people safely and all the necessary recruitment checks for new staff should be obtained before they start working with the people who live at the home. These steps will help to make sure that Care Homes for Older People Page 7 of 28 the staff are suitable to work with the people who live at Summerville and can provide safe care for them. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although assessments were being done on peoples needs before they moved into Summerville, the staffing levels needed to improve to ensure that all the needs of the people living at and moving into the home could be met. Evidence: In November 2009, we carried out a short inspection at Summerville because of concerns raised by relatives visiting the home. We found that the staffing numbers were not adequate to meet the needs of the people living at the home. This was discussed with the manager at the time and she agreed that people with high dependency and complex needs should not be moved into the home until the staffing numbers had increased. This was to make sure the peoples needs could be met when they moved in. At this visit to the home, we looked at the checks that had been done on the needs of two people who had moved into the home not long before this visit. The information we saw showed that one person had high dependency needs. Their level of dependence and our previous findings about staffing levels meant that people Care Homes for Older People Page 10 of 28 Evidence: living at the home could be at risk of not having their needs met. Action was being taken at the time of this visit to recruit more staff for day and night duty to address this problem. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person living at the home has a care plan that shows what their needs are and how these should be met but problems with staffing levels meant that peoples dignity was not being maintained. Evidence: We looked at the care plans of six people who live at Summerville and who had varying needs. Four of these were written in a person centred way. They were detailed about each persons needs and included information to guide staff on how to meet those needs. All the plans of care we looked at during our visit were reviewed each month so that any changes were identified quickly. A moving and handling assessment had been completed on each resident so that staff would know how to move them safely but two that we saw had not been updated to reflect changes in there persons condition so it was not clear that the staff were working with correct up to date information. A nutritional assessment had been filled in so that staff would know if the residents were at risk of losing weight. Weights were recorded weekly or monthly so there was a regular check to show what was happening Care Homes for Older People Page 12 of 28 Evidence: with each person. The care plans that we saw had information about peoples choices and preferences, such as when they liked to get up, where they spent their day and how their spiritual needs were met. Visits made to them from health care professionals such as GPs, nursing home co-ordinators and district nurses were recorded so staff would know when these visits had taken place and why. The daily records were detailed so that all staff would know what had taken place during the shift. We looked at checks that had been made on some care plans and the changes that needed to take place to improve these had not been completed. Visitors we spoke with felt that their relatives did not receive care in the way that the care plan said they should. We found that care plans had not been updated to reflect the changing needs of the person and how they needed some of their personal care to be provided. The relatives told us they had discussed the matter with the manager but felt that things had not improved but things get better for a while if you speak to the trained staff . Relatives also told us that their relatives who live in the home were not receiving help with personal care such as being taken to the toilet often enough. This meant that peoples dignity was not being maintained. They told us, it is not right that people are sat in wet pads. Some relatives said that they visited the home to make sure their relative was being given regular drinks and being taken to the toilet. There were a large number of slings kept in the home to be used with the various hoists. However, we could find no evidence that a particular sling for had been ordered following a request from relatives. Staff we spoke with told us they are rushed and sometimes people who live in the home had to wait before being taken to the toilet. Complaints had been made about staff not completing fluid balance charts but people spoken with said this was improving. We checked the fluid balance charts that were being kept for people living at Summerville to check on how much fluid they received throughout the day and found these had been fully completed on the day of this visit. When we made our short visit to the home in November 2009, we spoke with a number of visitors and the staff on duty at that time. All were of the opinion that the numbers of staff on duty were insufficient to meet the needs of the people living at the home. Since that visit action has been taken by the managers to recruit more staff to increase the numbers of people working at night and on the morning shift. Relatives we spoke with during this visit told us that the buzzers were not being answered quickly . This was difficult to assess on the day of our visit as electricians were Care Homes for Older People Page 13 of 28 Evidence: working on the call bell system and it was switched off for some parts of the day. Relatives we spoke with thought, the staff are lovely but there arent enough of them, the staff work hard and the staff are very nice but always rushed. We looked at the way medicines are managed in the home. There are policies and procedures are in place for the safe management of medications and staff training has taken place so that staff are aware of their responsibilities regarding the safety of medicines in the home. A monitored dosage blister pack system is used in the home so staff can see which medicines have been given out each day. All medication administration record sheets we checked had been properly completed. Some people living in the home had been prescribed medicines that can be misused. These are called controlled drugs and special procedures were in place to make sure these were being managed safely and legally. We looked at the records for these medicines and found that they were also being managed safely so that they could be properly accounted for and people were receiving them as they had been prescribed. Items with a short shelf life once opened being kept in the medicines fridge had been dated and signed so that staff would know when these had been opened. The medicines are checked every month so that any errors were identified and dealt with quickly. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a range of activities for people to take part in so they can stay socially active and there is a good choice of meals so that people enjoy a varied diet to help them stay well and healthy. Evidence: Activities available for people who live at Summerville are varied and take place each day. Information about what is happening is on the notice board in the dining room and kept in each bedroom. The activities co-ordinator records what activities each person has joined in with in their care plan. This helps to show that people continue to join in activities, have the opportunity for social interaction and what activities they enjoy. Each month, entertainers visit the home. Relatives we spoke with confirmed there was a range of activities that people who live in the home could be involved in. People who live at the home also confirmed there were activities each day which they could take part in if they wished. Relatives confirmed that they were welcome at the home but were asked not to visit during meal times. This was causing distress to some relatives. The menu we saw included a good range of choice and people we spoke with told us Care Homes for Older People Page 15 of 28 Evidence: the food at the home was good. When we visited the home in November 2009, the lunch time meal had been served over an hour late. Staff told us this sometimes happens as it takes a long time to take people to the table. When staffing numbers are increased the problem should be alleviated. The meals were on time on the day of this visit. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have received training to make sure they know what to do to protect people living at Summerville from abuse but people who live in the home and their visitors felt their complaints and concerns had not been listened to so no action had been taken to resolve them. Evidence: When we made out short visit to the home in November 2009, we found that the complaints records were not well kept records had been put into a better order so it was possible to see complaints had been recorded and what action was being taken to deal with them. Some information from head office still had to be up dated. People we spoke with knew who to speak to if they had concerns or complaints but said that they had no confidence that their complaints would be listened to or dealt with. The records we saw showed that eleven complaints had been received at the home since July 2009 and these are around the same issues, such as fluid balance charts not being completed, drinks being left out of reach of people in bed and in the lounge, people not being taken to the toilet regularly or when they ask, call bells not being answered quickly and not enough staff on duty. They said that they felt that the meetings held by the senior managers of the company that runs the home had been helpful. Two further complaints about Summerville have been sent to us since our visit in November. We also looked at the arrangements in the home to make sure that people living there Care Homes for Older People Page 17 of 28 Evidence: are safeguarded from abuse and poor practice. Most of the staff working at the home have received training in how to protect peoples rights. This training is also included in the induction of new staff. This, together with the policies and procedures, means that staff have the guidance they need to make sure that they know what to do to protect people living in the home from abuse. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Summerville is well maintained so the people who live there do so in clean, comfortable and safe surroundings. Evidence: At the time of this visit, Summerville was decorated to a good standards. We had seen some complaints saying that the home was not clean but at our visit in November 2009 and at this one, we found that the home was cleaned to a good standard and there were no unpleasant odours. In the main lounge there is a large nurses station. The sides of this are high which means that staff are unable to observe the people sitting in the lounge and it could be seen as a barrier to communication. Staff can be heard on the telephone discussing aspects of care with GPs, dietitians and other health professionals which is a breach of confidentiality of the people living in the home. Residents and relatives we spoke with felt the nurses station was intrusive into the living space. There was evidence of gloves and aprons to help staff make sure that infection is not spread through the home. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were not enough staff available to make sure that the needs of the people living at Summerville could be met and there were gaps in staff training and recruitment that could mean the people living at the home were not safe from harm or injury. Evidence: We found there are not enough staff on duty to meet peoples needs and people who live in and visit the home said they thought that there were not enough staff on duty on each shift. This was highlighted in complaints about the home made to the commission and found to be the case when we carried out a short inspection at the home in November 2009. Relatives said that, the staff are good but too busy and buzzers are not answered quickly. Staff we spoke with told us that they felt they could not answer buzzers quickly and that they felt that they could not care for people properly because they were too busy. The management are addressing this shortfall by recruiting new staff to increase the numbers at the busy times and at night. We saw from the staff records that only seven of the staff working in the home have achieved a national vocational qualification in care. These are nationally recognised qualifications for staff working in care and show they have been assessed as competent to provide good quality care. At Summerville, some staff had formal training to carry out their roles but the number with these qualifications is below the expectations of the national minimum standards. Other staff members were Care Homes for Older People Page 20 of 28 Evidence: undertaking the course and a further number of staff had been enrolled to start their courses not long after our visit to the home. The records we saw showed staff training was on-going and that staff had received mandatory training in some key subjects such as fire safety and safeguarding. This means that staff have been given the skills to promote peoples health and welfare. Staff we spoke with confirmed that this training has taken place. We found that twenty two out of fifty five members of staff had received up to date moving and handling training in the twelve months before our visit. It is important that all staff receive this training regularly to make sure they have up to date information on how to help move people safely without injury. We looked at the staff files of three members of staff who had started working at the home not long before our visit. We found that a member of staff had started working in the home before a POVA (protection of vulnerable adults) check had been applied for. This person had a Criminal Records Bureau disclosure but this was from a previous employer and at the time of our visit were not transferable. We also found that a work permit for another staff member had not been updated to ensure that they could still work in this country. One file was found to have all the relevant checks. These checks are necessary to help make sure that the staff members are suitable to work with the people who live at Summerville. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of management needs to improve to ensure the home is managed well in the best interests of the people who live there. Evidence: The manager of the home is an experienced nurse who has the relevant management qualifications and has applied to be registered with the commission. The manager was not on duty on the day of this visit and two experienced managers from the company that runs the home were present. Staff we spoke with said they do not feel supported by the manager and that the manager is not very visible within the home. They told us they thought that the trained staff (nurses) were supportive. Relatives we spoke with said that they had no confidence that their complaints and concerns were listened to and acted upon. We saw records that showed that monthly checks are carried out on all care and support systems in the home. There was an action plan to make some changes to the care plans, put together as a result of an audit. However, some of these changes had not taken place and no one had checked to see if the work had been done. Care Homes for Older People Page 22 of 28 Evidence: We looked at how the people who live at the home and their relatives are consulted about the what happens in the home. Regular meetings with the manager are held with the people who live at the home and their families but we found that some issues raised by families had not been acted upon. From the staff training records, we found that staff training on up to date moving and handling needs to be improved so that staff are sure they can move people safely. We looked at how the health and safety of the people who live at the home is protected and found that there are regular checks on all equipment. We also saw that necessary checks are carried out to the services of the building. These checks help to make sure that the home is a safe place to live and work in. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 16 22 The complaints log needs to be more organised so an audit trail can be followed. So that the management is aware of which complaints have been actioned. 27/11/2009 2 27 18 The needs and dependency 27/11/2009 levels of all people living at the home must be assessed. Night time must be assessed as a priority. So that there is adequate staff on duty to fully meet the needs of the people living there at all times. Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be updated to reflect the changing needs of the people living at the home So that the staff are aware of changes to their care. 15/01/2010 2 8 16 Following individual assessments, appropriate moving and handling slings must be provided for all people who live at the home. This is so that people can be moved safely and taken to the toilet. 15/01/2010 3 10 12 There must be enough staff on duty at all times to make sure that the personal care needs of the people living at the home, such as being taken to the toilet, can be met. This is to make sure that people receive the care they 15/01/2010 Care Homes for Older People Page 25 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action need when they need it so that their dignity can be maintained. 4 16 22 Complaints and concerns raised by people who live at the home and their relatives should be recorded and fully investigated. The investigation, outcome and action taken to resolve the complaint should also be recorded. This is to help make sure that people can be confident that their complaints and concerns are taken seriously, investigated and acted upon. 5 27 18 The staffing numbers and skill mix available throughout the day and night must be sufficient to meet the needs of the people living in the home. This is to make sure that peoples needs can be met in the way the prefer. 6 28 18 All staff at the home must receive up to date moving and handling training So that people living in the home are not placed at possible risk of injury. 29/01/2010 29/01/2010 15/01/2010 Care Homes for Older People Page 26 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 7 29 19 Staff must not start working with the people living in the home until all the necessary checks have been obtained. This is to help make sure that new staff are suitable to work with the people who live at Summerville. 15/01/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 It is recommended that people who have been assessed as having high dependency needs do not move into the home until the staffing numbers increase. This is to make sure that people and the staff know that there are sufficient resources to meet the needs of everybody living at Summerville. It is recommended that an alternative to the nurses station is found as people can not be observed and people in the lounge can overhear confidential information about other people living in the home. 2 19 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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